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Physician payment reform is gaining traction because more experts believe quality of care improvements will not happen without fundamentally changing how doctors are reimbursed. Physicians have a big effect on quality and cost of care, but experts said performance measures and public reporting are not enough to generate the improvements needed in the health system.

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The Center for Health Quality and Innovation will coordinate care and improve quality for the University of California's five academic medical centers, 10 hospitals and 16 professional schools. The center will be a clearinghouse for best practices and provide financial support for projects that improve wellness and enhance the way care is delivered.

The three-hospital Southcoast Health System in New England has seen $20 million in cost savings using Lean Six Sigma tools over the past two years. Southcoast prioritized patient care and safety processes and implemented projects to improve those areas first.

A heart disease management program using electronic medical records and computerized registries saved lives, reduced hospital admissions and lowered costs, according to a Kaiser Permanente Colorado study. The data was used to match patients to personal nurses and clinical pharmacy specialists who helped them comply with treatment regimens.

Researchers found that disparities for heart attack survival rates in U.S. hospitals were largely unexplainable, with known factors such as location and the socioeconomic status of patients accounting for only 17% of the gap. The study underscores the need to identify more direct measures of quality to explain hospital gaps, as well as to understand aspects such as organizational culture and teamwork among staff, researchers said.

Experts Peggy E. Delany and Thomas S. Nelson offered six best practices that hospitals can adopt when deploying EHRs, including tailoring the technology to fit various user work flows. "You cannot implement the system to meet 100% of each individual's needs, but neither can you implement in a generic manner and assume that everyone will adjust," they said.